EZH2表达与结直肠癌肿瘤细胞增殖和血管生成及预后的关系  

Prognostic Value of EZH2,Ki-67 and CD34 Expression in Patients with Surgically Treated Colorectal Cancer

作　　者：侯鸿发 苏永辉[1] 卜巨源[1] 王霄 侯冰宗[1] 

机构地区：[1]中山大学附属第五医院胃肠外科,广东珠海519000

出　　处：《中山大学学报（医学科学版）》2017年第6期866-872,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省珠海市科技计划项目(20171009E030027)

摘　　要：【目的】探讨果蝇zeste基因增强子同源物2(EZH2)表达与结直肠癌肿瘤细胞增殖、血管生成及预后的关系。【方法】采用免疫组织化学Max Vision两步法检测110例手术切除的原发性结直肠腺癌组织中EZH2、增殖细胞核抗原(Ki-67)和CD34标记血管内皮细胞计数肿瘤微血管密度(i MVD)的表达情况,并分析其与结直肠癌临床病理特征的关系。用Pearson相关系数分析EZH2、Ki-67及i MVD表达的相关性。用Kaplan-Meier法分析生存曲线,多变量Cox比例风险回归模型筛选影响患者生存的独立预后因素。【结果】结直肠癌组织的EZH2、Ki-67及i MVD阳性表达率分别为40.91%(45/110)、57.27%(63/110)和46.36%(51/110)。结直肠癌远处转移患者的EZH2蛋白阳性表达率高于无远处转移患者(P=0.024)。Ki-67与原发灶大小、肠壁浸润深度、AJCC分期、分化程度密切相关(P=0.033~0.015)。i MVD与肿瘤的肠壁浸润深度、AJCC分期、分化程度密切相关(P=0.016~0.034)。Spearman相关分析显示EZH2与Ki-67呈正相关(r=0.195,P=0.041),而与i MVD的表达无关;Ki-67与i MVD呈正相关(r=0.213,P=0.025)。多因素分析结果表明,EZH2蛋白的表达是结直肠癌患者预后差的独立影响因素(HR 1.965,95%CI 1.019~3.789,P=0.044)。【结论】结直肠癌组织中EZH2过表达与肿瘤细胞的增殖活性有关,在一定程度上EZH2具有判断结直肠癌切除术后转移和预后的价值。【Objective】To evaluate the expression of enhancer of zeste homolog 2(EZH2),Ki-67 and intratumoral microvaseular density(i MVD)in human colorectal cancer(CRC),and discuss their relationship with the biological behavior and prognosis.【Methods】The expression of EZH2,Ki-67 and i MVD(labeled by CD34 protein)was measured with immunohistochemical Max Vision method in CRC patients followed up over 5 years.【Results】Positive expression rates of EZH2,Ki-67 and i MVD were 40.91%(45/110),57.27%(63/110)and 46.36%(51/110),respectively. EZH2 expression was positively correlated with distant metastasis(P=0.024). Ki-67 expression was positively correlated with tumor size,infiltration depth,AJCC stage and differentiation(P=0.033~0.015). The i MVD expression was positively correlated with infiltration depth,AJCC stage and differentiation(P=0.016~0.034).Spearman correlation analysis showed that EZH2 expression was positively correlated with Ki-67 expression(r=0.195,P=0.041),whereas negatively correlated with i MVD expression. Ki-67 expression had a positive correlation with i MVD(r=0.213,P=0.025).Multivariate analysis suggested that the EZH2 expression was an adverse independent factor for survivals of CRC patients(HR 1.965,95%CI:1.019-3.789,P=0.044 for OS).【Conclusion】EZH2 expression was significantly correlate with the proliferation of tumor cells and may plays an important role in the metastasis and prognosis of CRC.

关 键 词：结直肠癌 EZH2 KI-67 CD34 预后 

分 类 号：R735.3[医药卫生—肿瘤]